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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Muscle weakness and Neuropathy

Introduction

Differential Diagnosis of Muscle weakness and Neuropathy

Differential Diagnosis of Muscle weakness and Neuropathy

Organ system Disease Symptoms History Physical

Examination

Diagnosis
Age of onset Muscle weakness Fever Myalgia Contractures Gait abnormality Neuropathy Atrophy Stiffness Myoglobinuria Other features Laboratory Findings Creatine Kinase Muscle Biopsy Electromyogram
Medication−induced Alcohol[1] Variable Proximal − − − + +/− − − −
  • Monspecific and are normal in many patients
  • Normal or ↑↑
  • Normal
  • Normal
Endocrine Diabetic infraction[2] 45  Proximal + + − − + + − −
  • Normal
  • Normal
Inflammatory/ Rheumatologic Fibromyalgia[3] 40−50s Generalized − − − − + − − −
  • Normal
  • Normal
  • Normal
  • Normal
Organ system Disease Age of onset Muscle weakness Fever Myalgia Contractures Gait abnormality Neuropathy Atrophy Stiffness Myoglobinuria Other features History Physical

Examination

Laboratory Findings Creatine Kinase Muscle Biopsy Electromyogram
Infectious Lyme disease[4] Variable Proximal + + − +/− + − − −
  • H/o tick bite
  • Hiking trip
  • Clinical diagnosis
  • +Serology
  • N/A
  • N/A
  • N/A
Polio[5] <5 yrs Proximal − − − + + + − −
  • History of skipped immunization.
  • Isolation from pharyngealsecretions, CSF
  • Positive serology
  • N/A
  • N/A
  • Neurological pattern
Syphilis[6] Variable Negative − − − + + − − −
  • History of risk factors (MSM, unprotected sex, multiple sex partners)
  • N/A
  • N/A
  • N/A
Organ system Disease Age of onset Muscle weakness Fever Myalgia Contractures Gait abnormality Neuropathy Atrophy Stiffness Myoglobinuria Other features History Physical

Examination

Laboratory Findings Creatine Kinase Muscle Biopsy Electromyogram
Neurologic ALS[7] >35 Proximal
&
Distal
  • Distal
 − − − − + + + −
  • N/A
  • Clinical diagnosis
  • Normal
  • Nonspecific findings of chronic denervation with reinnervation
  • Neuropathic
Stroke[8] >65 Proximal
&
distal 		− − − + + + − −
  • Weakness of the involved arm
  • Head CT
  • Normal
  • Normal
  • Neuropathic
Multiple Sclerosis[9] 30’s Proximal
&
distal 		− − − + + − − −
  • Attacks or exacerbation
    • Localized weakness
    • Focal sensory disturbances
    • Hyper reactive reflexes
    • Increased tone or stiffness
  • Head CT ologo−clonal bands
  • Normal
  • N/A
  • Neuropathic
References

References

  1. ↑ Preedy VR, Adachi J, Ueno Y, Ahmed S, Mantle D, Mullatti N, Rajendram R, Peters TJ (November 2001). “Alcoholic skeletal muscle myopathy: definitions, features, contribution of neuropathy, impact and diagnosis”. Eur. J. Neurol. 8 (6): 677–87. PMID 11784353.
  2. ↑ Horton WB, Taylor JS, Ragland TJ, Subauste AR (2015). “Diabetic muscle infarction: a systematic review”. BMJ Open Diabetes Res Care. 3 (1): e000082. doi:10.1136/bmjdrc-2015-000082. PMC 4410119. PMID 25932331.
  3. ↑ Ohara N, Katada S, Yamada T, Mezaki N, Suzuki H, Suzuki A, Hanyu O, Yoneoka Y, Kawachi I, Shimohata T, Kakita A, Nishizawa M, Sone H (2016). “Fibromyalgia in a Patient with Cushing’s Disease Accompanied by Central Hypothyroidism”. Intern. Med. 55 (21): 3185–3190. doi:10.2169/internalmedicine.55.5926. PMC 5140872. PMID 27803417.
  4. ↑ Schoenen J, Sianard-Gainko J, Carpentier M, Reznik M (August 1989). “Myositis during Borrelia burgdorferi infection (Lyme disease)”. J. Neurol. Neurosurg. Psychiatry. 52 (8): 1002–5. PMC 1031843. PMID 2795056.
  5. ↑ Howard RS (June 2005). “Poliomyelitis and the postpolio syndrome”. BMJ. 330 (7503): 1314–8. doi:10.1136/bmj.330.7503.1314. PMC 558211. PMID 15933355.
  6. ↑ French P (January 2007). “Syphilis”. BMJ. 334 (7585): 143–7. doi:10.1136/bmj.39085.518148.BE. PMC 1779891. PMID 17235095.
  7. ↑ Zarei S, Carr K, Reiley L, Diaz K, Guerra O, Altamirano PF, Pagani W, Lodin D, Orozco G, Chinea A (2015). “A comprehensive review of amyotrophic lateral sclerosis”. Surg Neurol Int. 6: 171. doi:10.4103/2152-7806.169561. PMC 4653353. PMID 26629397.
  8. ↑ Baldwin K, Orr S, Briand M, Piazza C, Veydt A, McCoy S (May 2010). “Acute ischemic stroke update”. Pharmacotherapy. 30 (5): 493–514. doi:10.1592/phco.30.5.493. PMID 20412000.
  9. ↑ Goldenberg MM (March 2012). “Multiple sclerosis review”. P T. 37 (3): 175–84. PMC 3351877. PMID 22605909.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]